- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $474.77 / $2,124.00 / $7,316.00
| Facility | | $474.77 | $2,124.00 | $7,316.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.01 / $436.13 / $668.50
| Professional | | $308.01 | $436.13 | $668.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $245.79 / $473.58 / $1,131.61
| Facility | | $245.79 | $473.58 | $1,131.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $308.12 / $409.20 / $639.78
| Professional | | $308.12 | $409.20 | $639.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $292.57 / $292.57 / $447.96
| Facility | | $292.57 | $292.57 | $447.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $336.48 / $336.48 / $347.48
| Facility | | $336.48 | $336.48 | $347.48 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $337.08 / $454.38 / $678.68
| Professional | | $337.08 | $454.38 | $678.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $2,339.76
| Facility | | $55.00 | $55.00 | $2,339.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,483.44 / $3,144.32 / $3,607.95
| Professional | | $2,483.44 | $3,144.32 | $3,607.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.07 / $446.55 / $692.85
| Facility | | $332.07 | $446.55 | $692.85 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $363.29 / $524.83 / $713.76
| Professional | | $363.29 | $524.83 | $713.76 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $315.07 / $421.95 / $655.83
| Professional | | $315.07 | $421.95 | $655.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.07 / $446.70 / $704.03
| Facility | | $332.07 | $446.70 | $704.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $344.66 / $469.51 / $703.97
| Professional | | $344.66 | $469.51 | $703.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,120.00 / $3,264.00 / $7,600.00
| Facility | | $1,120.00 | $3,264.00 | $7,600.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $310.97 / $414.16 / $598.83
| Professional | | $310.97 | $414.16 | $598.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.34 / $404.12 / $569.63
| Professional | | $358.34 | $404.12 | $569.63 |